What is progressive muscle relaxation?
The positive effects of relaxation and the contributory influences of prolonged stress and tension on illness have long been recognized. Progressive muscle relaxation (PMR) is a technique aimed at reducing the somatic (bodily) consequences of stress, such as muscle tension, by lowering physiologic arousal and, thereby, inducing relaxation.
Commonly used models of progressive relaxation are based on the principles identified by American psychiatrist Edmund Jacobson in the 1930s. The basic technique developed by Jacobson involves alternately tensing and relaxing major muscle groups of the body, while concurrently focusing on sensations associated with the tensing and relaxing.
Regardless of the reasons for its application, current PMR methods begin with a rationale for its use. The fundamental premise is that muscle tension, even when it is not overtly perceived, causes anxiety (and often pain, discomfort, and agitation) and that significant a reduction in associated symptoms will result if tense muscles are relaxed.
Participants learning PMR are requested to loosen tight clothing and to sit in a comfortable chair in a quiet setting relatively free from distraction. A trained therapist then instructs and demonstrates how to isolate, tense, and relax muscles, and then systematically guides the person through the different muscle groups in a fixed order.
During the “tensing” phase of the procedure, the person is directed to constrict the identified muscle as tightly as possible while keeping other muscle groups loose and relaxed. Attention is directed to the sensations associated with tensing, such as tightness and discomfort. The tensing phase lasts approximately ten seconds and is followed by the “relaxing” or “releasing” phase, wherein muscles tension is “let go” and muscles are allowed to become limp. The participant then focuses on the feeling of tension and discomfort draining from the muscle and takes notice of the contrast between the warmth and comfort of relaxed muscles and the discomfort of tensed muscles.
After about ten to fifteen seconds of relaxing, the sequence is repeated with another muscle group. A typical sequence of muscle groups addressed in the technique is the following: hands, biceps and triceps, shoulders, chest, neck, mouth and lips, eyes, forehead and scalp, back, stomach, thighs, calves, feet, and toes. After completing the sequence of tensing and releasing phases, participants take an “inventory” of their muscle groups and relax those with remaining tension. The procedure takes about twenty to thirty minutes to complete.
During the procedure, participants are encouraged to avoid blocking thoughts that might intrude upon their consciousness, and either to allow these thoughts to flow through their mind or to shift their focus toward their breathing if they find themselves distracted. For a period of time following the exercise, participants may engage in slow, steady, and even breathing as a means of enhancing the relaxation response. They may also repeat a calming word or phrase such as “relax,” “release,” or “let go” each time they exhale so that the word or phrase becomes a cue for promoting relaxation, a practice known as cue-controlled relaxation.
Typically, two or three guided relaxation sessions are conducted to develop basic proficiency with the exercise. Nonguided practice sessions are encouraged to further enhance skills, with the goal of the person being able to achieve a highly relaxed state without guidance. Common variations to the procedure include abbreviated protocols such as “release only” methods, whereby the tensing phase is eliminated or emphasis is directed at specific muscle groups that are identified as particularly key in inducing overall relaxation. Audiotapes of the relaxation procedure may also be used to develop relaxation skills.
PMR has been found to affect the autonomic nervous system, which, among other functions, regulates how the body reacts to changes in the environment. These effects include decreases in heart rate, blood pressure, and muscle tension, and general arousal. Vasodilation of blood vessels also occurs, causing increased blood flow throughout the body, most noticeably in the extremities. These responses are the opposite of those produced by anxiety and lead to subjective feelings of warmth, comfort, and calmness.
PMR has a long history of use in psychiatry, psychology, and behavioral medicine. The procedure has been employed as a stand-alone therapy and as a component of multifaceted protocols treating psychiatric and medical illnesses. In nonmedical settings, the procedure is commonly used to promote overall wellness and healthy adaptation to life stressors.
A large body of research has demonstrated that PMR is effective in reducing symptoms stemming from a variety of medical and psychiatric conditions. A double-blind, placebo-controlled study in 2005 examined the technique as applied in a medical setting. The study showed that asthmatic female adolescents’ lung function, heart rate, and blood pressure improved after learning and employing PMR. Another double-blind, placebo-controlled study, in 2009, examined the technique’s psychiatric application. The study found that PMR improved anxiety symptoms in hospitalized adults with schizophrenia.
Trained and licensed mental health or medical professionals should be consulted for persons seeking PMR treatment for psychiatric, psychological, or medical conditions. For nonmedical applications, trained nonprofessionals and audiotapes are usually appropriate.
Before participating in PMR, interested persons should consult a physician or other health care provider.
Chen, W. C., et al. “Efficacy of Progressive Muscle Relaxation Training in Reducing Anxiety in Patients with Acute Schizophrenia.” Journal of Clinical Nursing 18, no. 15 (2009): 2187-2196.
Neumann, Donald A. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 2d ed. St. Louis, Mo.: Mosby/Elsevier, 2010.
Nickel, C., et al. “Effect of Progressive Muscle Relaxation in Adolescent Female Bronchial Asthma Patients.” Journal of Psychosomatic Research 59 (2005): 393-398.